Neoadjuvant Chemoimmunotherapy Versus Standard Chemoradiotherapy for Locally Advanced Esophageal Squamous Cell Carcinoma
- Journal
- Annals of surgical oncology (Q1)
- Published
- 17 August 2026
- Study design
- Retrospective cohort
- Evidence level
- Level 3, Low (CEBM 3b)
- Authors
- Yong Ao, Changsen Leng, Junying Chen, Kongjia Luo, Lu Shao, Qianwen Liu, et al.
- PMID
- 42606652
- DOI
- 10.1245/s10434-026-20342-8
Why clinicians should know about it
- Picked for Surgery (paper of the day, 22 August 2026): Improved OS, lower recurrence with NCIT in ESCC
Abstract
BACKGROUND: The long-term survival outcomes of neoadjuvant chemoimmunotherapy (NCIT) compared with neoadjuvant chemoradiotherapy (NCRT) for locally advanced esophageal squamous cell carcinoma (LA-ESCC) remain unclear. METHODS: Patients with LA-ESCC who underwent curative esophagectomy after receiving either NCRT or NCIT between June 2007 and December 2022 were retrospectively analyzed. The patients in the NCRT group received a uniform regimen of vinorelbine and cisplatin with concurrent radiotherapy, whereas those in the NCIT group received a PD-1 inhibitor combined with chemotherapy. Pathologic outcomes, overall survival (OS), and disease-free survival (DFS) were compared between the groups before and after application of inverse probability of treatment-weighting (IPTW). RESULTS: Overall, 462 patients were included (232 with NCIT; 230 with NCRT). The median follow-up period was 51.5 months (interquartile range, 33.0-87.0 months). The IPTW-adjusted analyses showed higher 3-year OS with NCIT versus NCRT (79.7 vs 68.2%; hazard ratio [HR] 0.51; 95% confidence interval [CI] 0.28-0.91; P = 0.023). Multiple sensitivity analyses yielded consistent results. The 3-year DFS did not differ significantly between the two groups (73.9 vs 62.7%; HR, 0.65; 95% CI 0.40-1.05; P = 0.076). Pathologic complete response rates were comparable (NCIT, 33.6% vs NCRT, 41.0%; P = 0.229). Within 2 years postoperatively, NCIT had lower rates of overall recurrence (15.8 vs 28.8; P = 0.033) and distant metastases (6.6 vs 17.0%, P = 0.006) than NCRT, whereas the locoregional recurrence rate was similar (8.7 vs 11.8%; P = 0.592). CONCLUSIONS: In this retrospective cohort of selected patients with LA-ESCC who completed neoadjuvant therapy and underwent curative resection, NCIT was associated with better OS than NCRT.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.